Abrasive cytologic brush



June 17, 1958 K. s. MaCLEAN 2,339,049

ABRASIVE CYTOLOGIC BRUSH I Filed March 25. 1954 2 Sheets-Sheet l I N VEN TOR. lYeWnr/fi 5. Malta?) FIG.5

ATTORNEYS June 17, 1958 K. s. Ma LEAN ABRASIVE CYTOLOGIC BRUSH 2Sheets-Sheet 2 Filed March 25, 1954 INVENTOR. ffezmef/ 5. Jf'acleanATTORNEYS United States Patent ABRASIV E CYTOLOGIC BRUSH Kenneth S.MacLean, New York, N. Y. Application March 25, 1954, Serial No. 418,551

14 Claims. (Cl. 128-2) The present invention relates, in general, tocytology, and, in particular, to an instrument for removing cells byabrasion from various parts of a patients body.

In attempting to diagnose a patient for the presence of cancer, it is awell known practice to use a curette to obtain a tissue specimen of thesuspected part of the patients body for study and examination. However,this procedure could be quite dangerous in that if cancer is present,the cancerous tissue may be cut into and, as a result thereof, cancercells may enter the blood and/ or lymphatic circulations and spreadthroughout the body. According to the procedure of exfoliative cytologydeveloped by Papanicolou, this danger may be avoided. In the practiceofthe latter procedure, cells are removed by aspiration for laboratorystudy and examination for determining Whether or not they are cancerous.However, the Papanicolou procedure does not provide for a positiveremoval of the cells since it depends upon the existence of surfacecells which have exfoliated from a part of the body and can be removedby aspiration from the body. In view of the foregoing, the primaryobject of the present invention is to provide a means for obtaining forexamination cells from a suspected part of the patients body which meansprovides for a positive removal of the cells from the body tissure whileobviating the danger of cutting into cancerous tissue.

Another object is to provide a cytologic instrument for the removal, byan abrasive procedure, of surface cells from an internal part of thepatients body.

Another object is the provision of an abrasive cytologic instrumentwhereby the cells which have been removed from an internal body part,are prevented from being lost or rubbed off by contact with the patientsbody during their removal from the patients body.

A further object is the provision of an abrasive cytologic brush whereinthe brush member is expendable so that a new brush can be provided foreach patient, or separate brushes can be provided for obtaining cellspecimens from different parts of the patients body.

A still further object is the provision of an arrangement to facilitatethe manipulation of a cytologic instrument within the patients body Theabove and other objects, features and advantages of the presentinvention will be more fully understood from the following descriptionconsidered in connection with the accompanying illustrative drawings.

In the drawings, which illustrate the best mode presently contemplatedby me of carrying out the invention:

Fig. l is a side view of an abrasive cytologic brush, pursuant to thepresent invention, for obtaining cell specimens from a patients uterusor womb, the brush member thereof being illustrated in its operativedisposition after insertion of the instrument into the patients body;

. Fig. 2 is a longitudinal sectional view, on an enlarged scale, takenon the line 2-2 of Fig. 1;

Fig. 3 is a fragmentary View, similar to Fig. l, of the ICE handle endof the abrasive cytologic brush, the handle being illustrated in aretracted position thereof;

Fig. 4 is a cross-sectional view, on an enlarged scale, taken on theline 44 of Fig. 2;

Fig. 5 is a sectional view on an enlarged scale taken on the line 55 ofFig. 2;

Fig. 6 illustrates the abrasive cytologic brush in an operativedisposition thereof relative to the patients body which is illustratedmore or less diagrammatically;

Fig. 7 is a side view of a laryngeal abrasive cytology brush pursuant tothe present invention; and

Fig. 8 is a longitudinal sectional view, on an enlarged scale, taken onthe line 88 of Fig. 7.

Referring now to Figs. 1-6 in detail, there is illustrated an abrasivecytologic brush or cytologic instrument 10 for obtaining cell specimensfrom a patients womb or uterus. Briefly described, the instrument 10comprises a brush holder 12, a brush member 14 releasably secured to thebrush holder, and a shield 16 within which the brush holder 12 isdisposed for relative movement.

As here shown, the brush holder 12 is constituted by an elongatedtubular member 18 preferably formed'of stainless steel or other suitablematerial and provided at one end thereof with a handle 20 which ispreferably force-fit about said member at one extremity thereof. It willbe noted that the handle extends outwardly beyond the adjacent end ofthe tubular member 18 and is provided with a bore 22 which communicateswith the hollow center of the tube 18.

In order to releasably secure the brush member 14 within the tubularholder 12, provision is made for a brush retaining means, hereconstituted by the chuck 24. As here shown, the chuck 24 is constitutedby a split collet 26 which is provided with a head or finger piece 28.The collet 26 is provided with an externally threaded portion 25 forthreaded engagement within the internally threaded bore 22 of the handle29. The collet is also provided with a tapering portion 30 constitutedby the split segments 32 which are defined by the splits 34. An openingor bore 36 (Fig. 4) is provided in the chuck for the insertion of oneend of the stem 38 of the brush member 14. The bore 22, in the handle20, is provided with an unthreaded tapering portion or clamping surface46 which is complementary to the split segments 32.

From the foregoing, it will be understood that the head 28 of the chuck24 may be rotated in a counter-clockwise direction, viewing Fig. 6 toretract the chuck from the full line position thereof illustrated inFig. 2 for withdrawing the split segments 32 from the brush clampingdisposition thereof to release the stem 38 of the brush member 14.Actually only a few turns of the head 28 are required for the release ofthe brush stem 38. With the chuck 24 in said partially retractedposition thereof, the stem 38 of another brush 14 may be inserted intothe opening 36, which is in registry with the bore in the tubular member18, and the head 28 may then be rotated in a clockwise direction forurging the chuck 24 into the handle 20, the split segments 30 beingforced together by the tapering bore portion 40 resulting in theclamping of the brush stem 38 in the chuck 24, to releasably secure thebrush member 14 to the brush holder 12.

As here shown, the brush member 14 is provided with the previouslymentioned elongated stem 38 which is preferably formed of twisted zinccoated steel wires. At the end thereof opposite the end which isreleasably secured in the chuck 24, the stem 38 is provided with thebrush bristles 42 which may be formed of either natural or syntheticmaterial. The bristles extend in all directions from the stem. At thebristled end thereof, the stem 38 is capped with a cap 44 preferablyformed from a suitable smooth plastic material.

It will be understood that the brush member 14 is expendable, servingfor only a single patientuse after which it is discarded.

The shield 16 is an elongated tubular member preferably formed ofstainless steel. At one end thereof, the shield 16 is provided withaknurled head or finger portion 41, and at the other end thereof theshield is provided with a slight curvature or arcuate portion, asindicated at 43, to facilitate the passage thereof through the vaginalcanal into the uterus or womb of the patient. The shield 16 is providedwith an adjustable collar or detent member 46 which is slidably movablelongitudinally thereof and which is. provided with a knurled set screw48 to releasably secure the detent in adjusted position longitudinallyof the shield 16. The detent 46 serves to limit the extent of entry ofthe instrument into the patients body, which'is indicated at P in Figs.2 and 6. Provision is also made on the tubular shield 16 for anadditional adjustable collar 52 which is slidably movable longitudinallythereof and which is provided also with a knurled set screw 54 foradjustably securing the collar 52 in position longitudinally of theshield. The collar 52 is additionally provided with an extending arm orelement 56, the function of which will presently appear.

As previously indicated, with the chuck 24 partially ret-racted 'fiomits full-line position in Fig. 2, the brush l4 may-be readily secured tothe tubular brush holder 12 by inserting the stem 38 through the curvedend 43- of'the shield into the holder 12 and through the latter into thechuck opening 36defined by split segments 32. The chuck is then rotatedin a direction for axial movement thereof into the handle to clamp theend of the stem 1 into the holder through the cooperating action of thetapered bore portion 40 in the handle and the split segments 32. Thehead. 41 of the shield 16 may then be grasped in one. hand and thehandle 20 of the brush holder 12. may be grasped in the other hand. forpulling the handle 20 outwardly of the shield, as indicated by the arrow58 in Fig. l, to withdraw the bristles 42 into the shield so as not tovproject therefrom. The detent 46 is then adjusted longitudinally of theshield 16 to accommodate the particular patient. It will be understoodthat the handle 20 will nowbe retracted from the finger piece 42- toexpose a substantial length of holder tube 18. The latter may besuitablygraduated or indexed as indicated by the spaced lines or markings 66(Fig. 3) which are preferably calibrated in centimeters.

In order to facilitate the insertion of the abrasive cytologic brush 10into the uterus or womb, a forcep or body-grasping instrument 60 (Fig.6) may first be inserted through the vaginal canalv to grasp the cervix,as illustrated more or less diagrammatically in Figure 6. Whileretaining the hold on the cervix, the abrasive cytologic brush 10 istheninserted through the vaginal canal into the uterus or womb, theinsertion thereof being limited by the abutment of the detent 46 againstthe patients body P. The previously mentioned collar 52 is then adjusteduntil the arm 56 thereof is in position to engage into either of thefinger-openings 62 of the forcep, or within the opening 64 thereof. Thisinterengagement of both instruments will serve to steady and support theinstrument 10 during the use thereof. The doctor may now grasp both theinstrument 10 and the forcep 60 in the same hand, and with the otherhand he may grasp the handle 20 and urge the latter inwardly of theinstrument 10, as from the broken line position thereof illustrated inFig. 6 to the full line position thereof resulting in the movement ofthe bristles 42 to a position outwardly of the shield 16 and within thewomb, as in Fig. 6, The graduations 66 will indicate the extent ofpenetration of the bristles, 42 into. the womb or uterus. It will benoted that during said movement of the brush member 14 into the womb,outwardly of the shield 16, the substantially rigid holder 12 serves thefunction of constituting a guide for the comparatively more flexiblewire. stem 38 as well as serving as a holder for the brush. The brushmember may be manipulated within the womb by rotation of the holderhandle 20 in opposite directions to rotate the brush bristles to andfrom the full line and broken line positions thereof illustrated inFigure 2. This causes the bristles to rub against the surfaces of thewomb so as to elfect a positive removal by abrasion, of cells ment 10.In this connection, the handle 20 of the brush holder 12 is now moved inthe opposite direction, namely from the full line to the broken lineposition thereof, as in Fig. 6, to withdraw or retract the bristles 42completely into the shield 16. 'The arm 56 of the collar 52 is nowdisengaged from the forcep 60 and theentire instrument 10 is withdrawnfrom the patients body. I The brush 14, provided with the cell specimenswhich have been removed from the body, may now be readily removed fromthe instrument 10 by returning the handle 20 to the full line position.thereof, to a point where an unbristled portion of the stem 38 projectsfrom the shield 16, as in Fig. 2. This unbristled portion of the stemmay then. be grasped and the chuck head 28 rotated a few turns topartially retract the chuck for releasing the stem from the holder. p

While the shielded abrasive cytologic brush 10 has been illustratedandfdescribed in connection withits use for removing cells or specimensfrom the uterus or womb, it will be understood that the presentinvention is-not limited for use in the specifically described body partor cavity. It iswithin the scope, of the present invention to provide ashielded abrasive cytologic brush: for other body passages or cavities.For example and not byway of limitation, a shielded abrasive cytologicbrush can be used for'insertion into the nasal, passages, urinarybladder,

rectum, sigmoid colon, bronchus, oesophagus, stomach,v

peritoneal cavity, etc., it being understood that the shield 16 would beprovided, in each case, with the proper curvature or shape toaccommodate the specific passage, and

that the instrument would be dimensioned to accommodate the specflicpassage. In any case, the shield 16 would facilitate the entry of theinstrument into the par ticular body passage and would. serve to preventthe loss of the cells or specimens, by body contact, during theWithdrawal of the instrument from the body. v Referring now toFigs. 7and 8 in detail, there is illustrated an embodiment of the presentinvention for use in a body passage or opening of such size as toobviate the necessity for the previously described shield in view ofment 70 is constituted bya brush holder 72, which'is substantiallysimilar to the previously described brush holder 12, and by a brushmember 74, which is substantially similar to the previously describedbrush member 14. The brush holder 72 is constituted by an elongatedtubular member 76 preferably formed of stainless steel, and provided atone end with a handle 78 which is preferably force fit thereon. Thehandle 78 is'provided with the previously mentioned chuck 24, whichcooperates in the previously described manner with a handle bore 22having a tapering portion 40, to releasably secure the stem 38 of thebrush member 74 in the brush holder 72. While in the previouslydescribed embodiment, the brush holder 12 was a straight or linearmember, with substantially no curvature therein, the brush holder 72 isspethe trachea, and for this purpose is provided with the arcuateportion 80 from which the bristles 42 of the brus 74. project.

While grasping the handle 78, the laryngeal cytology brush 70 may bereadily inserted into the larynx and trachea of the patient andmanipulated therein so that the bristles 42 will rub or abrade theadjacent tissue surfaces to remove surface cell specimens therefrom. Theinstrument 70 is then withdrawn from the patients throat and, due to therelative diameters of the instrument 70 and the laryngeal and trachealopenings, there is no danger of the bristles 42 rubbing against adjacentbody tissues during the removal of the instrument 70. As in thepreviously described embodiment It the brush 74 of the presentembodiment is also expendable, a new brush member being used with eachpatient. The brush may be readily removed from the instrument, aspreviously described, by a partial retraction of the chuck 24, only twoor three turns thereof being necessary, and a new brush may then beinserted into the holder 72, the stem 38 thereof being in automaticregistry with the opening in the chuck 24 when inserted into the shield72. The chuck is then tightened to securely retain the brush in theholder 72. It will be noted that in the present embodiment, the holder72, in addition to its function in holding the brush for the insertionthereof into the patients body, also serves as a guide for the brush,since, as previously indicated, the holder is substantially rigid andthe stem 38 is comparatively flexible, relative thereto.

The shield 16 of the cytologic instrument can be used as a cannula orcatheter for injecting carbon dioxide or radio opaque substances intobody cavities. For example, and not by way of limitation, the shield 16abov e can be inserted into the uterus and the head 3-1 thereofconnected by a tube to a tank of carbon dioxide for de termining whetherbody passages leading to and from the uterus are blocked. Similarly,with the shield inserted in the uterus, radio opaque substances can beinserted through the open head 41 thereof into the uterus for takingX-rays.

While I have shown and described the preferred embodiments of myinvention, it will be understood that various changes may be made in thepresent invention Without departing from the underlying idea orprinciples of the invention within the scope of the appended claims.

Having thus described my invention, what I claim and desired to secureby Letters Patent, is:

1. A cytologic instrument comprising a device having a holder which isprovided with means for removing cells by abrasion from a part of apatients body, said holder having provision to guide said abrasive meansduring the insertion thereof into and the removal thereof from thepatients body, and means for releasably securing said abrasive means tosaid holder, whereby to provide said instrument with a new abrasivemeans for each patient use thereof, said securing means comprising achuck provided on said holder for releasably holding said brasive meansin operative disposition thereof.

2. An abrasive cytologic instrument comprising a device having a holderprovided with an abrasive brush for removing cells by abrasion from apart of a patients body, and said holder being substantially rigid forguiding the brush into and out of an opening in a patients body, and achuck provided on said holder for releasably retaining said brush inoperative disposition.

3. A cytologic instrument comprising a device having a holder which isprovided with means for removing cells by abrasion from a part of apatients body, said holder for said abrasive means, and a shield forsaid abrasive means, said holder being movable relative to said shieldfor moving said abrasive means into a shielded disposition thereof toprevent contact of said abrasive means with the patients body duringwithdrawal of the instrument therefrom.

4. A cytologic instrument comprising a device having a holder which isprovided with means for removing cells by abrasion from a part of apatients body, said holder for said abrasive means and a shield for saidabrasive means, said holder being movable relative to said shield formoving said abrasive means into a shielded disposition thereof toprevent contact of said abrasive means with the patients body duringwithdrawal of the instrument therefrom, and adjustable detent meansprovided on said shield for limiting the insertion of said instrumentinto the patients body.

5. A cytologic instrument comprising means for removing cells byabrasion from a part of a patients body, and a holder for said abrasivemeans having provision to guide the latter during the insertion thereofinto and the removal thereof from the patients body, and a memberprovided on said instrument for releasable inter-engage ment with abody-grasping instrument, whereby to facilitate the operation of saidcytological instrument.

6. A laryngeal abrasive cytologic instrument comprising a tubular holdermember, a brush provided with a stern extending into said holder andhaving bristles disposed outwardly of one end of said holder member,said holder member being provided with an arcuate portion adjacent saidone end to facilitate the entry of said instrument into a patientslarynx for operatively disposing said brush in the larynx or trachea,and a handle provided on said holder at the other end thereof, saidhandle having provision to secure said brush stem in said holder.

7. A laryngeal abrasive cytologic instrument comprising a tubular holdermember, a brush provided with a stem extending into said holder andhaving bristles disposed outwardly of one end of said holder member,said holder member being provided with an arcuate portion adjacent saidone end to facilitate the entry of said instrument into a patientslarynx for operatively disposing said brush in the larynx or trachea,and a handle provided on said holder at the other end thereof, and achuck provided in said handle for releasably securing said stem in saidholder.

8. A holder for a cytologic brush comprising an elongated tubular memberadapted to receive a brush stem therein, a handle provided on saidtubular member, and a releasable chuck provided in said handle forreleasably securing the brush stem in said tubular member.

9. A holder for a cytologic brush comprising an elongated tubular memberadapted to receive a brush stem therein, a handle provided on saidtubular member, and

a chuck provided in said handle for releasably securing the brush stemin said tubular member, said member being curved to facilitate the entrythereof into a body opening.

10. An abrasive cytologic instrument comprising an elongated tubularmember adapted to receive a brush stem therein, means on said member forreleasably securing the brush stem thereto, and a tubular shield forentry into a patients body, said tubular member being mounted withinsaid shield for relative movement, whereby the brush can be withdrawninto the shield after an abrading operation thereof on a body part toprevent contact between the brush and the patients body as theinstrument is withdrawn therefrom.

11. An abrasive cytologic instrument comprising an elongated tubularmember adapted to receive a brush stem therein, means on said member forreleasably securing the brush stem thereto, and a tubular shield forentry into a patients body, said tubular member being mounted withinsaid shield for relative movement, whereby the brush can be withdrawninto the shield after an abrading operation thereof on a body part toprevent contact between the brush and the patients body as theinstrument is withdrawn therefrom, a handle provided on said tubularmember, and a chuck provided in said handle for releasably securing thebrush stem in said tubular member.

12. An abrasive cytologic instrument comprising an elongated tubularmember adapted to receive a brush curing the brush stem thereto, and atubular shield for entry into'a patients body said tubular member beingmounted within said shield for relative movement, whereby the brush canbe withdrawn into the shield after an abrading operation thereof on abody part to prevent contact between the brush and the patients body asthe instrument is withdrawn therefrom, and a part provided on saidshield for inter-engagement with a body-grasp- I ing instrument,wherebyto facilitate thetoperation of said cytological instrument.

13. An abrasive cytologic instrument comprising an elongated tubularmember adapted to receive a brush stern therein, means on said memberfor releasably securing the brush stem thereto, and a tubular shield forentry into a patients body, said tubular member being mounted withinsaid shield for relative movement, whereby the brush can be withdrawninto the shield after an abrading operation thereof on a body part toprevent contact between the brush and the ;patients body as theinstrument is withdrawn therefrom, and adjustable detent means providedon said shield fortlimiting the im sertion of said instrument intothepatients body.

14. An abrasive cytologic instrument comprising a brush provided with anelongated stem, an elongated tubu lar brush holder intowhich said stemextends, a part provided on said holder for releasably securing saidstem thereto, and a tubular shield within which said'holderis mountedfor relative movement, the bristles of said brush normally extendingoutwardly of said shield during an abrading operation of said instrumentwithin the patients body, and said holder being operable to withdrawsaid bristles into said shield to prevent contact of saidtbristles andthe patients body during removal of the instrument.

References Cited in the file of this patent UNITED STATES PATENTSJeifreys Apr. 30, 1929 Martin Sept. 23,1930

